Deep Infiltrating Endometriosis
The deep infiltrating endometriosis (DIE) scan is a thorough assessment of the uterus, ovaries, bowel, bladder, ligaments, and surrounding structures for those with pelvic pain.
It requires transvaginal assessment for accurate diagnosis however we no longer require bowel preparation.
Superficial endometriosis can be thought of as disease that is just on the surface. When endometriosis grows into tissues and organs, like ovaries and the bowel, we consider this as deep infiltrating disease.
What is Deep Infiltrating Endometriosis?
A standard pelvic ultrasound will look at the uterus, ovaries, and the immediate surrounds (the adnexa). A DIE ultrasound looks at all these organs as well as looking at specific locations where endometriosis typically likes to develop such the anterior rectum, the ligaments that support the pelvis, the bladder, and fallopian tubes. It takes around twice as long as a normal pelvic ultrasound and requires an internal ultrasound to see the organs and tissues of the pelvis well.
Benefits of undergoing a DIE Ultrasound?
Initially DIE ultrasounds were described to assist in planning surgery and assessing for deep disease that may involve other surgeons. These days, the diagnostic benefits of these more thorough examinations help general practitioners to provide more accurate counselling, treatment options and more importantly helps you to understand your pain to make informed decisions on your treatments.
MRI versus Ultrasound
No type of imaging is perfect. Ultrasound and MRI both have excellent rates of identifying deep endometriosis however ultrasound has benefits of lower cost, functional (movement) assessment, as well as is high accuracy of pelvic disease. Both MRI and ultrasound require high levels of interpretation, as endometriosis can be subtle, and it is important that these studies are reported by medical professional’s adept at both image interpretation as well as clinical understanding of the disease.
